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Skin concerns

Excessive sweating

Sweating far more than needed, typically in the underarms or palms.

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What it is

Sweating far more than is needed. It shows up mostly in the underarms, palms, soles and face.

Why it happens

It is not that the sweat glands are more numerous or larger, but that the signal to sweat is excessive. The primary form arises without an underlying disease and usually begins young.

Where to start

This is the concern on this site with the most placebo-controlled trials behind it. The steps are relatively clear, so you can work up from topicals to procedures.

There are no numbers and no citations in this box. What has been established, and how far, is below.

This is the concern on this site with the most placebo-controlled trials behind it.

On other concerns we write, again and again, that the comparator was another product and so 'neither worked' cannot be ruled out. Here it is different — botulinum toxin has a 322-person, 52-week placebo-controlled trial, and microwave treatment has a sham-controlled trial.

And precisely because of that, this concern also shows best how far a placebo moves.

  • In the botulinum trial, 25% of the placebo group reached a two-point improvement in severity
  • In the microwave trial, 54% of the sham group were classed as responders

More than half the people who received a fake procedure reported that their sweating had dropped. Those two figures are worth remembering whenever you read a number from an uncontrolled study.

Sweating a lot and having hyperhidrosis are not the same thing. The trials here mostly enrolled people scoring 3–4 on a severity scale (HDSS) — that is, people whose daily life is affected. Diagnosis belongs to clinicians.

Evidence level
Moderate evidenceOther

Aluminium salts (antiperspirants)

An ingredient class — not a single line on an ingredient list

In a 50-person randomised trial, aluminium chloride and aluminium lactate reduced axillary and inguinal sweating comparably, and the lactate had better tolerability. But both arms received an aluminium salt, and there was no arm applying nothing. What botulinum toxin and microwave have under the same sweating concern is missing here.

Clinical procedures related to this concern

Procedures are not listed alongside topical ingredients. They are not something you use at home.